Peters Catherine, Brooke Ivan, Heales Simon, Ifederu Adeboye, Langham Shirley, Hindmarsh Peter, Cole Tim J
Department of Endocrinology (C.P., S.L., P.H.), and Chemical Pathology, Laboratory Medicine (I.B., S.H., A.I.), Great Ormond Street Hospital, London WC1N 3JH, United Kingdom; and Population, Policy, and Practice Programme (T.J.C.), UCL Institute of Health, London WC1N 1EH, United Kingdom.
J Clin Endocrinol Metab. 2016 Sep;101(9):3445-9. doi: 10.1210/jc.2016-1822. Epub 2016 Jul 11.
There is variability in the congenital hypothyroidism (CH) newborn screening TSH cutoff across the United Kingdom.
To determine the influences of year, gender, and ethnicity on screening variability and examine whether there is an optimal operational TSH cutoff.
Single center, retrospective population study using blood spot TSH cards received by the Great Ormond Street Hospital Screening Laboratory between 2006 and 2012.
A total of 824 588 newborn screening blood spot TSH cards.
Blood spot TSH results were recorded with demographic data including the Ethnic Category Code.
The proportions of samples exceeding different TSH cutoffs, ranked by ethnicity.
The proportion of samples exceeding the TSH cutoff increased over time, with the cutoff at 4 mU/L, but not at 6 mU/L. There was a consistent trend with ethnicity, irrespective of cutoff, with the odds ratio of exceeding the TSH cutoff lowest (∼1.0) in White babies, higher in Pakistani and Bangladeshi (>2.0), and highest in Chinese (>3.5).
The blood spot TSH screening data demonstrate a clear ranking according to ethnicity for differences in mean TSH. This suggests that there may be ethnic differences in thyroid physiology. Ethnic diversity within populations needs to be considered when establishing and interpreting screening TSH cutoffs.
英国各地先天性甲状腺功能减退症（CH）新生儿筛查促甲状腺激素（TSH）临界值存在差异。
确定年份、性别和种族对筛查差异的影响，并检查是否存在最佳的操作TSH临界值。
采用大奥蒙德街医院筛查实验室在2006年至2012年期间收到的血斑TSH卡片进行单中心回顾性人群研究。
总共824588张新生儿筛查血斑TSH卡片。
记录血斑TSH结果以及包括种族类别代码在内的人口统计学数据。
按种族分类，超过不同TSH临界值的样本比例。
超过TSH临界值的样本比例随时间增加，临界值为4 mU/L时如此，但6 mU/L时并非如此。无论临界值如何，种族方面都存在一致趋势，白人婴儿中超过TSH临界值的比值比最低（约为1.0），巴基斯坦和孟加拉裔婴儿中较高（>2.0），华裔婴儿中最高（>3.5）。
血斑TSH筛查数据显示，根据种族，平均TSH差异存在明显排序。这表明甲状腺生理学可能存在种族差异。在建立和解释筛查TSH临界值时，需要考虑人群中的种族多样性。
